title: Left ventricular rotation and torsion in patients with perimembranous ventricular septal defect.
abstract: BACKGROUND
  Assessment of left ventricular (LV) rotation has become an important approach for quantifying LV function. In this study, we sought to analyze LV rotation and twist using speckle tracking imaging (STI) in adult patients with isolated ventricular septal defects.
  
  
  METHODS
  Using STI, the peak rotation and time to peak rotation of 6 segments in basal and apical short-axis were measured, respectively, in 32 patients with ventricular septal defect and 30 healthy subjects as controls. The global rotation of the 6 segments in basal and apical and LV twist versus time profile were drawn, the peak rotation and twist of LV were calculated. All the time to peak rotation/twist were expressed as a percentage of end-systole (end-systole = 100%). Left ventricular ejection fraction was measured by biplane Simpson method.
  
  
  RESULTS
  In patients group, the peak rotation of posterior, inferior, and postsept wall in basal was higher(P ≤ 0.05) and LV twist was also higher (P ≤ 0.05) than healthy controls. There were no significant differences between 2 groups in the peak rotation of the other 9 segments and left ventricular ejection fraction. Different from the control group, the time to peak rotation of the 6 segments in basal were delayed and the global rotation of the base was delayed (P ≤ 0.05) in ventricular septal defect group.
  
  
  CONCLUSIONS
  Left ventricular volume overload due to ventricular septal defect has significant effect on LV rotation and twist, and LV rotation and twist may be a new index predicting LV systolic function.
authors.affiliation: Intensive Care Unit, Jiangsu Province Hospital of Traditional Chinese Medcine, Nanjing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhuang
authors.forename: Yong-hong
authors.initials: YH
authors.lastname: Yong
authors.forename: Jing
authors.initials: J
authors.lastname: Yao
authors.forename: Ling
authors.initials: L
authors.lastname: Ji
authors.forename: Di
authors.initials: D
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D015588:Observer Variation; D011446:Prospective Studies; D012016:Reference Values; D012720:Severity of Illness Index; D014102:Torsion Abnormality / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D054159:Torsion, Mechanical; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult
keywords: left ventricular rotation; speckle tracking imaging; twist; ventricular septal defect